You Can Get Norovirus from Eating at a Restaurant, Not Just on a Cruise, Warn the CDC

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If you think norovirus outbreaks occur mostly on cruise ships, you may want to think again, especially before dining out.

According to the Centers for Disease Control and Prevention’s (CDC) recent Vital Signs report,
outbreaks of norovirus on cruise ships represent only about one percent
of all reported norovirus outbreaks. Foodborne norovirus outbreaks can
occur any place food is served.

The CDC analyzed 2009 to 2012 data
through the National Outbreak Reporting System (NORS) and found that
during the four-year period, a total of 4,318 norovirus outbreaks were
reported to NORS, resulting in 161,253 illnesses, 2,512
hospitalizations, and 304 deaths.

Foodborne transmission was the
primary mode reported in 1,008 (23 percent) norovirus outbreaks,
representing 48 percent of the 2,098 foodborne outbreaks reported with a
single suspected or confirmed cause during the four-year study period.

Bare-Hand Contact with Food

Factors
contributing to food contamination were reported in 520 (52 percent) of
1,008 foodborne norovirus outbreaks, among which infectious food
workers were implicated as the source of contamination in 364 (70
percent). Bare-hand contact with ready-to-eat foods was explicitly
identified in 196 (54 percent) of these outbreaks.

Ready-to-eat
foods are foods that are ready to be served without additional
preparation, such as washed raw fruits and vegetables for salads or
sandwiches, baked goods, or items that have already been cooked.

Food service workers have been observed to practice proper hand-washing only one of four times that they should.

Norovirus Takes a Toll on People and the Healthcare System

Symptoms
of norovirus include vomiting, diarrhea, and sometimes fever, although
norovirus infections also can be asymptomatic, according to the CDC.

According
to the CDC, each year an estimated 19 to 21 million cases of norovirus
disease occur, including 1.7 to 1.9 million outpatient visits, 400,000
emergency department visits, 56,000 to 71,000 hospitalizations, and 570
to 800 deaths, which result in approximately $777 million in healthcare
costs.

Rates of severe outcomes, such as hospitalization and
death, are greatest in children less than five years of age, and in
adults 65 years and older.

Norovirus is hard to kill. It remains
on food, kitchen surfaces, and utensils. It can remain infectious on
foods even at freezing temperatures and until heated above 140°F.
Norovirus also stays on countertops and serving utensils for up to two
weeks and is resistant to many disinfectants and hand sanitizers,
according to the CDC.

Tips to Prevent Outbreaks

Weighing in on the report, Alissa Rumsey, a
registered dietitian and spokesperson for the New York State Dietetic
Association, told Healthline, “Foodborne illness is a serious problem. Have you
ever had the "24 hour bug"? You may have had a bout of food poisoning.
Proper hand washing is one of the keys to preventing contamination of
food, especially when it comes to norovirus. Be sure to wash your hands
thoroughly for 20 seconds with soap and water. This is important not only
for restaurant workers, but in your own home as well. Rather than avoid
certain foods, practice safe food handling instead."

The CDC urge the food service industry to help prevent norovirus outbreaks by:

Ensuring
that food service workers practice proper hand-washing and avoid
touching ready-to-eat foods, such as raw fruits and vegetables, with
their bare hands before serving them.